Acute Wounds Research Articles

Ag nanocomposite hydrogels with immune and regenerative microenvironment regulation promote scarless healing of infected wounds

BackgroundBacterial infection, complex wound microenvironment and persistent inflammation cause delayed wound healing and scar formation, thereby disrupting the normal function and appearance of skin tissue, which is one of the most problematic clinical issues. Although Ag NPs have a strong antibacterial effect, they tend to oxidize and form aggregates in aqueous solution, which reduces their antibacterial efficacy and increases their toxicity to tissues and organs. Current research on scar treatment is limited and mainly relies on growth factors and drugs to reduce inflammation and scar tissue formation. Therefore, there is a need to develop methods that effectively combine drug delivery, antimicrobial and anti-inflammatory agents to modulate the wound microenvironment, promote wound healing, and prevent skin scarring.ResultsHerein, we developed an innovative Ag nanocomposite hydrogel (Ag NCH) by incorporating Ag nanoparticles (Ag NPs) into a matrix formed by linking catechol-modified hyaluronic acid (HA-CA) with 4-arm PEG-SH. The Ag NPs serve dual functions: they act as reservoirs for releasing Ag/Ag+ at the wound site to combat bacterial infections, and they also function as cross-linkers to ensure the sustained release of basic fibroblast growth factor (bFGF). The potent antibacterial effect of the Ag NPs embedded in the hydrogel against S.aureus was validated through comprehensive in vitro and in vivo analyses. The microstructural analysis of the hydrogels and the in vitro release studies confirmed that the Ag NCH possesses smaller pore sizes and facilitates a slower, more sustained release of bFGF. When applied to acute and infected wound sites, the Ag NCH demonstrated remarkable capabilities in reshaping the immune and regenerative microenvironment. It induced a shift from M1 to M2 macrophage polarization, down-regulated the expression of pro-inflammatory factors such as IL-6 and TNF-α, and up-regulated the expression of anti-inflammatory IL-10. Furthermore, the Ag NCH played a crucial role in regulating collagen deposition and alignment, promoting the formation of mature blood vessels, and significantly enhancing tissue reconstruction and scarless wound healing processes.ConclusionsWe think the designed Ag NCH can provide a promising therapeutic strategy for clinical applications in scarless wound healing and antibacterial therapy.Graphical

A Comprehensive Review on Platelet-Rich Plasma Activation: A Key Player in Accelerating Skin Wound Healing.

Platelet-rich plasma (PRP) activation is emerging as a promising and multifaceted tool for accelerating skin wound healing. This review extensively examines PRP's role in wound healing, focusing on its composition, mechanisms of action, activation methods, and clinical applications. PRP's potential to enhance both chronic and acute wound healing and its applications in cosmetic and aesthetic procedures are explored. Furthermore, this review investigates safety concerns, including adverse reactions, infection risks, and long-term safety implications. Looking to the future, emerging technologies, combination therapies, personalized medicine approaches, and regulatory developments are discussed, pointing towards an important and transformative era in wound healing and regenerative medicine. With its wide-ranging implications for healthcare, PRP activation has the potential to become a ubiquitous and essential therapeutic option, improving patient outcomes and reducing healthcare costs.

Assessment of Wound Care Products at Major Retailers in Accordance with the American Academy of Dermatology’s Recommendations

Background: Proper wound care is important for improving healing outcomes and minimizing long-term effects of scar formation. Selection of appropriate care may be challenging for individuals due to overabundance of product selection, and conflicting evidence on common wound care products, which may pose a risk for delayed wound healing. 
 Objective: We aimed to assess whether wound care products sold by major retailers, specifically Walmart, Walgreens, and Target, align with the recommendations on patient support information websites provided by the American Academy of Dermatology.
 Methods: A unique search inquiry was established for each major retailer, and analysis of their first aid wound care sections was performed.
 Results: 393 Walgreens, 334 Walmart, and 285 Target products were included. 0% of wound cleansing products available were recommended by the academy. Petroleum-based products were represented in 61% in Walgreens, 76.2% in Walmart, and 78.4% in Target products assessed. In total, 61.6% of products in Walgreens, 57% in Walmart, and 52.7% in Target were consistent with AAD recommendations for providing appropriate wound coverage.
 Conclusion: Many products sold in retailers are not recommended in managing acute minor wounds; appropriate counseling from the AAD may provide insight to optimizing wound care and scar minimization.

THE ROLE OF PROPHYLACTIC ANTIBIOTICS IN ZONE II AND ZONE V ACUTE FLEXOR TENDON INJURIES

Our study sought to establish the necessity of prolonged pre-operative antibiotic prophylaxis in patients presenting with zone II and zone V acute flexor tendon injuries (FTI). We hypothesized that a single dose of prophylactic antibiotic was adequate in prevention of post-operative wound infection in acute zone II and V FTI.This was a prospective study of 116 patients who presented with zone II and zone V acute FTI. The study included patients who were 18 years and older. Those with macroscopic contamination, immunocompromised, open fractures, bite injuries, and crush injuries were excluded. Patients were randomised into a group receiving a single dose of prophylactic antibiotic and another group receiving a continuous 8 hourly antibiotic doses until the day of surgery. Each group was subdivided into occupational and non-occupational injuries. Their post-operative wound outcomes were documented 10 – 14 days after surgery. The wound outcome was reported as no infection, superficial infection (treated with wound dressings), and deep infection (requiring surgical debridement).There was 0.9% rate of deep post-operative wound infections, which was a single zone V acute FTI case in a single dose prophylactic antibiotic group. There was a 7.8% superficial post-operative wound infection rate, which was mainly zone II acute FTI in both antibiotic groups. There was a strong association between zone II acute FTI and post-operative wound infection (p < 0.05). There was no association between (antibiotic dosage or place of injury) with post-operative wound infection (p > 0.05).There is no benefit in prescribing prolonged pre-operative antibiotic in patients with acute, simple lacerations to zone II and zone V FTI if there is no macroscopic wound contamination.

PROPHYLAXIS AND MANAGEMENT OF PERIPROSTHETIC JOINT INFECTION (PJI) WITH HYPOCHLOROUS ACID

The incidence of PJI in knee replacements is 2.8% and slightly lower with hip replacement surgery. PJI make up 15% (or even more) of knee revisions. To combat PJI, antibiotic laden bone cement has been used for many decades, but antibiotic stewardship dictates more prudent management of antimicrobials. Projected increase in infection rate, due to increased surgery and latent infection to be almost 5-fold up to 2035.Biofilm is a complex structure of bacteria and polysaccharide matrix and, is recognised as a major component in PJI and other orthopaedic infections.Biofilm is responsible for high incidence of resistance to antimicrobials and ineffective host immune response.MethodStabilized hypochlorous acid has been reported to have a rapid kill rate on all pathogens, including MDR pathogens associated with chronic and acute wound infections. It destroys biofilm on contact, is not cytotoxic, reduces inflammation and stimulates wound healing. 0,038% of Hypochlorous acid was used as prophylaxis against infection and to treat PJI.We report on our experience with hypochlorous acid as a wound irrigation as prophylaxis against infection (more than 600 cases) and for PJI. We also report on a University study where a head to head analysis was done on the anti-biofilm efficacy between hypochlorous acid 0,038% (Trifectiv Surgical Wound Irrigation) and Product X (an industry-standard product for the prevention and treatment of biofilm infection.Hypochlorous acid offers a valuable addition to the armamentarium of wound antiseptics, with added anti-inflammatory value. An in vitro study demonstrated superior efficacy against biofilm when compared to Product X.

Ozonated saline intradermal injection: promising therapy for accelerated cutaneous wound healing in diabetic rats.

The use of ozonized water is gaining importance in medicine due to its effects on hyperglycemia and wound healing mechanisms. This experiment was conducted to assess the impacts of intradermal administration of ozonated water on acute skin wound healing in a diabetic rat model. Sixty-four adult male Wistar rats were randomly divided into two groups: an ozonated water group (O3W) and a control group (CG). Experimental diabetes was chemically induced in the rats by the intraperitoneal administration of 60 mg/kg streptozotocin. One week later, full-thickness skin surgical wounds (1 cm2) were created between the two shoulders of the rats under general anesthesia. The wounds were then daily irrigated with normal saline (CG) or intradermally injected with 1 mL of ozonated water at 10 mg/L O3W. Wound healing was evaluated through macroscopic analysis, measuring wound size, diameter, and percentage of contraction rate before wounding and at 3, 7, 9, 12, 14, 18, 21, 24, and 28 days post-wounding. On days 7, 14, 21, and 28 after induction of the wounds, the body weights and blood glucose levels of rats (8 per group) were measured before the rats were euthanized. Moreover, the morphological structure of the tissue, vascular endothelial and transforming growth factor (VEGF and TGF) affinity and gene expression were examined. The O3W group had significantly lower blood glucose levels and wound size and gained body weight. Additionally, epithelial vascularization, stromal edema, TGF, and VEGF gene expression significantly improved in the O3W group. Therefore, ozonated water has the potential to enhance and promote cutaneous wound healing in diabetic rats.

Dermatophytosis is uncommon in asymptomatic wild eastern cottontail rabbits in Illinois, Midwestern United States.

To investigate the presence of dermatophytes on the haircoat of wild eastern cottontail rabbits (ECR) (Sylvilagus floridanus) with and without skin lesions. 2-week-old or older ECR admitted to a Wildlife Medical Clinic (WMC) in central Illinois, Midwest United States, from September 2021 to August 2022. ECR were surveyed over a 1-year period to assess the prevalence and seasonality of dermatophytosis. A Wood's lamp exam was performed over the haircoat. Hairs were sampled with a sterile toothbrush and plated on Sabouraud dextrose agar. The plates were photographed twice weekly for 3 weeks, and colonies were identified as contaminants or dermatophytes. 523 ECR were admitted to WMC, 141 ECR met the age inclusion criteria, and 121 samples were plated. ECR presented as a litter were sampled together. None of the sampled ECR presented skin lesions other than acute traumatic wounds. No fluorescence was observed on any ECR during the Wood's lamp examination. Based on culture colony morphology, 115/121 of the samples were identified as contaminants and no growth was observed in 6/121 of plates. Dermatophytes' colonies were not identified on any of the culture plates. Dermatophytes are zoonotic fungi and can potentially be carried by wild animals. The fungal infection poses a health concern to humans and domestic pets through direct interaction. Our current results suggest that dermatophytosis may not be prevalent in asymptomatic wild rabbits in the studied areas of the Midwestern United States.

Determination of the sizes and structural elements of wounds based on the computer planimetry. A photo protocol in assessing the course of wound healing process

The article substantiates the relevance of computer planimetry as an integral indicator in assessing the course of wound process. The authors have concluded that currently, there is no any “off-line” computer program that not only measure wound area, but also determine its structural elements. An original author’s work is presented in the article – AnalyRan program (Russia, 2022). This program is designed for medical specialists involved in the treatment of simple and complex clean, conditionally infected and infected acute and chronic wounds of various etiology. The discussed program can quickly and accurately measure the wound area and provide the information on wound structural elements, such as necrosis, fibrin, granulation and epithelium. The information obtained contributes to a differentiated approach to the choice of curative tactics and allows to make an objective comparison of various local agents, namely, their effectiveness at the wound process. The flexibility of the program allows to have fine-tuned settings for a specific camera, smartphone, video camera with frame captures, with flash or its lack, natural or artificial lighting conditions. Potentials of the presented program contribute to its widespread routine use.

Fabrication and characterization of a hydrocolloid wound dressing functionalized with human placental derived extracellular matrix for management of skin wounds: An animal study.

Functionalization of wound dressing is one of the main approaches for promoting wound healing in skin wound management. In this study, our aim is to fabricate a bio-functionalized hydrocolloid wound dressing. The extracellular matrix (ECM) was extracted from human placental tissue. A hydrocolloid film was fabricated using Na-CMC, pectin, gelatin, styrene-isoprene-styrene adhesive, glycerol, and 0.5%-2.5% powdered ECM. A polyurethane film and a release liner were used in the hydrocolloid/ECM films. The mechanical, adhesion, swelling rate, and integrity of the films were investigated. Cell proliferation, adhesion, and migration assays, as well as, SEM and FTIR spectroscopy were also conducted. Macroscopic and microscopic evaluations of wound healing process and formation of blood vessels were conducted in mouse animal models. We successfully fabricated a three-layered ECM-functionalized hydrocolloid dressing with a water vapor transmission rate of 371 g/m2 /day and an adhesion peel strength of 176 KPa. Cellular adhesion, proliferation and migration were promoted by ECM. In the animal tests, ECM-functionalized hydrocolloids significantly improved wound closure and re-epithelialization at days 14 and 21. Also, ECM-functionalized hydrocolloids promoted the formation of hair follicles. Our findings suggest that ECM could enhance the wound healing properties of hydrocolloid wound dressings. This wound dressing could be considered for application in hard-to-heal acute wounds.

Evolving Role of Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d-) in Management of Trauma and Orthopaedic Wounds: Mechanism, Applications and Future Perspectives.

Negative Pressure Wound Therapy (NPWT) is a well-established method to promote wound healing by delivering negative pressure (a vacuum) at the wound site. Enhancement of NPWT techniques may allow an innovative way of treating trauma and orthopaedic wounds which provide unique challenges. We explore the role of negative pressure wound therapy with instillation and dwell time (NPWTi-d-) in the management of trauma and orthopaedic wounds. A comprehensive search strategy was conducted using databases of PubMed, Web of Science, Google Scholar, and Cochrane Library with the search words of 'NPWTid' or 'NPWTi-d-' or 'NPWT with instillation' or 'Negative pressure wound treatment with instillation' to generate this narrative review. The mechanism of action of NPWTi-d-, installation solutions and current applications in the trauma and orthopaedic wounds is evaluated. NPWTi-d-provides additional mechanism to promote wound healing in a spectrum of acute and chronic orthopaedic wounds. The technique allows local delivery of hydration and elution of antibiotics to support growth of healthy granulation tissue. Various mechanism of actions contribute in drawing the wound edges together, reduce oedema, help decontamination, deliver local antibiotic and promote healing. NPWTi-d- permits an enhanced, supplementary technique to encourage wound healing in challenging traumatic and orthopaedic wounds. Future applications of NPWTi-d- will depend on cost-effectiveness analysis and development of its application guidelines based on longitudinal, randomized controlled research trials.

An Advanced Review: Polyurethane-Related Dressings for Skin Wound Repair.

The inability of wounds to heal effectively through normal repair has become a burden that seriously affects socio-economic development and human health. The therapy of acute and chronic skin wounds still poses great clinical difficulty due to the lack of suitable functional wound dressings. It has been found that dressings made of polyurethane exhibit excellent and diverse biological properties, but lack the functionality of clinical needs, and most dressings are unable to dynamically adapt to microenvironmental changes during the healing process at different stages of chronic wounds. Therefore, the development of multifunctional polyurethane composite materials has become a hot topic of research. This review describes the changes in physicochemical and biological properties caused by the incorporation of different polymers and fillers into polyurethane dressings and describes their applications in wound repair and regeneration. We listed several polymers, mainly including natural-based polymers (e.g., collagen, chitosan, and hyaluronic acid), synthetic-based polymers (e.g., polyethylene glycol, polyvinyl alcohol, and polyacrylamide), and some other active ingredients (e.g., LL37 peptide, platelet lysate, and exosomes). In addition to an introduction to the design and application of polyurethane-related dressings, we discuss the conversion and use of advanced functional dressings for applications, as well as future directions for development, providing reference for the development and new applications of novel polyurethane dressings.

Janus polyurethane sponge as an antibiofouling, antibacterial, and exudate-managing dressing for accelerated wound healing.

The non-fouling condition, bacteria-free environment and suitable moisture at wound site are crucial for chronic wound healing. However, it remains highly meaningful yet challenging to develop wound dressings that can simultaneously achieve these desirable functions. In this work, a kind of multifunctional Janus polyurethane sponge (Janus-PU) was designed and fabricated by coating near-infrared (NIR)-responsive and superhydrophobic nanoparticles (F-ZnO@Ag NPs) on one surface of sponge. The nano-functionalized outer layer can endow Janus-PU with superhydrophobic antifouling property for preventing bacterial colonization and broad-spectrum antibacterial activity due to the presence of Ag NPs. Especially, the synergistic combination of asymmetric structure and strong NIR photothermal effect can impart Janus-PU with NIR-controlled unidirectional exudate removal, thus achieving an optimal wetting environment for wound healing. The mice full-thickness skin acute wounds treated with Janus-PU under NIR irradiation showed superior anti-infection and healing effect compared to the commercial dressings. Significantly, the treatment using Janus-PU with NIR irradiation can accelerate the recovery of methicillin-resistantStaphylococcus aureus(MRSA)-infected diabetic chronic wounds due to the synergistic effect of antibiofouling, antibacterial and exudate-managing. The Janus-PU as a promising multifunctional dressing can prevent bacterial invasion and create an appropriate environment for wound healing, providing an effective solution for intractable wounds and infections. STATEMENT OF SIGNIFICANCE: The development of advanced wound dressings to ensure non-fouling condition, bacteria-free environment and suitable moisture is crucial for chronic wound healing. However, it remains a considerable challenge to simultaneously integrate antibiofouling, antibacterial and exudate-managing properties into a single dressing. In this work, we developed a kind of multifunctional Janus polyurethane sponge (Janus-PU) by a single-sided superhydrophobic modification strategy, which can simultaneously achieve superhydrophobic antifouling property, effective broad-spectrum antibacterial and near-infrared controlled exudate removal. The Janus-PU designed herein can not only create an optimal environment for accelerated wound healing, but also avoid frequent dressing replacement, thus providing an ideal material system for intractable wounds and infections.

Epidemiology and early bacterial colonization of minor and moderate pediatric burns: A retrospective study from a developing country

ObjectivesInfection is still the leading cause of morbidity and mortality among burn patients worldwide. Isolation and identification of pediatric burn wound bacterial colonizers can prevent infection and improve burn trauma treatment. In this study, we explored early microbial colonizers within the burn wounds and the susceptibility of those isolates to antibiotics among hospitalized pediatric patients with minor and moderate burns, clinically significant infections and outcomes. MethodsA retrospective analysis of pediatric patients admitted to the inpatient pediatric surgical ward and treated for minor and moderate burns from 2009 to 2018 was performed. ResultsOne hundred six patients met the inclusion criteria. The mean age was 3.6 ± three years (0.2–14.1 years). The most common type of burn was scald burns (82.1%). The mean TBSA of the hospitalized pediatric burn cases was 8.5% (IQR, 6–12%). Seventy-nine (74.5%) patients had positive wound cultures at admission, regardless of the hospital admission day. Fifty-eight (73.4%) had one bacterial growth (mono isolate), while 21 (26.6%) had mixed growth or poly isolates. Among patients with mixed growth or poly isolate, 16 had two bacteria, three had three bacteria, and one had four bacteria isolated, totaling 105 isolated microorganisms (14 different species, 70.5% Gram-positive bacteria and 29.5% Gram-negative bacteria). Twelve patients (11%) developed clinically significant infections (eleven got burn wound infection, and one had septicemia). All patients received prophylactic systemic antibiotics. Only 35.2% of the isolated bacteria from the wounds were sensitive to the prophylactic antibiotics, and only ∼17% in case of clinically significant infections. We found a statistically significant difference in the length of hospital stay between patients with initially colonized samples of burn wounds compared with patients with initial negative samples (p = 0.008). All patients in the cohort survived hospital discharge. ConclusionDespite common bacterial colonization of acute burn wounds, only ∼10% of the patients developed clinically significant infections, a minority of which were sensitive to prophylactic antibiotics. Our findings indicate the need to refine the antibiotic approach in pediatric patients with minor/moderate burns in our local setting.

IMPACT OF HONEY DRESSING ON CHRONIC ULCER

Purpose: This study aims to highlight the significance of honey in wound treatment by focusing on its healing properties, main compounds responsible for healing capacity, its effectiveness in non-healing wounds, cost-effectiveness, and challenges coming its way. Background: Honey is an ancient treatment that is increasingly earning its place in modern wound care. Honey has been found to exert antioxidant, anticarcinogenic, anti-inflammatory, and antibacterial effects without antibiotic resistance, promote moist wound healing, and facilitate debridement. Composed of 80% sugar and 17% water, this supersaturated natural substance makes a splendid wound dressing. Its high osmolarity, phytochemicals, and enzymatic production of hydrogen peroxide inhibit bacterial growth, while its acidic pH and autolytic debridement, decrease inflammation and improve blood circulation to enhance epithelialization and healing with minimal scar tissue. Clinical observations suggest that honey holds significant promise as an effective treatment for several medical conditions, particularly in managing non-healing wounds. Large, contaminated wounds are difficult and expensive to treat. Thus, using honey can be an effective and economical approach to managing large wounds. Methods:A prospective observational study was conducted in the Department of General Surgery at Silchar Medical College and Hospital from August 2022 to April 2023, to evaluate the significance of honey dressing and related complications. This study included 25 cases with an average age of 38.18 (range 17-63) years, of these 19 were males and 6 were females. Result:In the results of the study, it was reported that honey in acute and chronic wounds provided rapid epithelization and wound contraction in wound healing, had anti-inflammatory and debridement effects, decreased pain, ensured infection control, shortened the time of wound healing, and was cost-effective.

Development of a prediction model of postpartum hospital use using an equity-focused approach

BackgroundRacial inequities in maternal morbidity and mortality persist into the postpartum period, leading to a higher rate of postpartum hospital use (PHU) among Black and Hispanic people. Delivery hospitalizations provide an opportunity to screen and identify people at high risk to prevent adverse postpartum outcomes. Current models do not adequately incorporate social and structural determinants of health (SSDOH), and some include race, which may result in biased risk stratification. ObjectiveOur objective was to develop a risk prediction model of PHU incorporating novel SSDOH using an equity approach. Study DesignWe conducted a retrospective cohort study using 2016-2018 linked birth certificate and hospital discharge data for liveborn infants in New York City. We included deliveries in 2016-2017 in model development, randomly assigning 70%/30% of deliveries as training/test data. We used deliveries in 2018 for temporal model validation. We defined Composite PHU as at least one readmission or emergency department visit within 30 days of the delivery discharge. We categorized diagnosis at first hospital use into 14 categories based on ICD-10 diagnosis codes. We tested 72 candidate variables, including social determinants of health, demographics, comorbidities, obstetric complications, and severe maternal morbidity. Structural determinants of health were racial-economic segregation at the zip code level using the index of concentration at the extremes (ICE) and publicly available indices of the neighborhood built/natural (BNE) and social/economic (SE) environment. We used four statistical and machine learning algorithms to predict Composite PHU, and an ensemble approach to predict Cause-specific PHU. We simulated the impact of each risk stratification method paired with an effective intervention on race-ethnic equity in PHU. ResultsThe overall incidence of PHU was 5.7%; the incidence among Black, Hispanic and White people was 8.8%, 7.4%, and 3.3%, respectively. Most common diagnoses for hospital use were general perinatal reasons (17.5%), hypertension/eclampsia (12.0%), non-gynecologic infections (10.7%), and wound infections (8.4%). Logistic regression with LASSO selection retained 22 predictor variables and achieved an auROC of 0.69 in the training, 0.69 in test, and 0.69 in validation data. Other machine learning algorithms performed similarly. Selected SSDOH features included ICE, insurance payor, depressive symptoms, and trimester entering prenatal care. The Cause-specific PHU model selected six of the 14 outcome diagnoses: acute cardiovascular disease, gastrointestinal disease, hypertension/eclampsia, psychiatric disease, sepsis, and wound infection, achieving an auROC of 0.75 in training, 0.77 in the test data, and 0.75 in the validation data using cross-validation approach. Models had slightly lower performance in Black and Hispanic subgroups. When simulating use of the risk stratification models with a postpartum intervention, identifying high-risk individuals using the Composite PHU model resulted in the greatest reduction in racial-ethnic disparities in PHU, compared to the Cause-specific PHU model or a standard approach to identifying high-risk individuals with common pregnancy complications. ConclusionA Composite PHU prediction model incorporating SSDOH can be used at delivery discharge to identify persons at risk for PHU..

FastSkin® Concept: A Novel Treatment for Complex Acute and Chronic Wound Management.

Successful treatments for acute and chronic skin wounds remain challenging. The goal of this proof-of-concept study was to assess the technical feasibility and safety of a novel wound treatment solution, FastSkin®, in a pig model. FastSkin® was prepared from skin micrografts patterned in blood using acoustic waves. Upon coagulation, the graft was transferred on a silicone sheet and placed on wounds. Six full-thickness wounds were created at the back of two pigs and treated with either FastSkin®, split-thickness skin graft (positive control), a gauze coverage (negative control, NC1), or blood patterned without micrografts (negative control, NC2). Silicone sheets were removed after 7, 14, and 21 days. Wound healing was monitored for six weeks and evaluated macroscopically for re-epithelialization and morphometrically for residual wound area and wound contraction. Tissue regeneration was assessed with histology after six weeks. Re-epithelialization was faster in wounds covered with FastSkin® treatments compared to NC2 and in NC2 compared to NC1. Importantly, an enhanced collagen organization was observed in FastSkin® in contrast to NC treatments. In summary, two clinically approved skin wound treatments, namely micrografting and blood clot graft, were successfully merged with sound-induced patterning of micrografts to produce an autologous, simple, and biologically active wound treatment concept.

Morphological Changes when Hemoben is Used in Bleeding from Acute Wounds of the Face-Jaw Area

One of the main issues of modern medicine, surgery, traumatology, urology, gynecology, neurosurgery, oncology, otorhinolaryngology, maxillofacial surgery is to stop the mine flow during and after surgery. In recent years, the number of local mining equipment has been increasing. This raises the question of whether these agents should be chosen based on their efficacy and safety. The value of a local anti-mine agent is limited in most studies to the study of its hemostatic effectiveness, that is, its main criterion is the question of stopping primary and secondary mining. But when using these drugs for cleaning wounds, studying the effect of the drug on soft tissues on the surface of the wound will help to positively resolve the issue of primary wound burns.
 Currently, due to the increasing exposure to anti-inflammatory substances in modern medicine, the development of new effective types of them is becoming an urgent issue. In this matter, local hemostatic drugs are of great importance. Local hemostatic drugs are used both for diffuse bleeding and for bleeding from large vessels. Today, there are various locally used hemostatic agents with different chemical compositions. Various chemical substances and their mixtures are used for their production. When checking the effectiveness of these substances, their safety level, ease of use, price and other factors are taken into account.
 Despite the large number of local mine suppressants, among them there are very few drugs that can be used universally.Therefore, the creation of highly effective local mine deterrents is an actual issue.

Combinatorial wound dressings loaded with synergistic antibiotics in the treatment of chronic infected wounds

Advanced medicated wound dressings fabricated by electrospinning and electrospraying were prepared for the eradication of topical bacterial infections potentially applied in the management of infected acute and chronic non-healing wounds. Two different antibiotics (ciprofloxacin and rifampicin), with different aqueous solubilities and different mechanisms of antimicrobial action, were loaded within electrosprayed polymer microparticles and within electrospun nanofibers, respectively, to provide the resulting wound dressing with dually controlled antibiotic release kinetics. Due to the large surface area per volume ratio of the electrosprayed microparticles containing ciprofloxacin, an initial burst release was obtained. Simultaneously, the reduced surface area per volume ratio for the electrospun nanofibers together with the reduced aqueous solubility of rifampicin produced an extended rifampicin release over time. More importantly, a synergistic antimicrobial effect against Gram-positive and Gram-negative bacteria was observed when both antibiotics were combined. Biofilm formation prevention and the elimination of already formed mature bacterial biofilms were also successfully achieved using our advanced dressings. The lack of cytotoxicity of the advanced wound dressings here reported against eukaryotic cells at antimicrobial doses was also demonstrated using three different mammalian cell lines. Moreover, the advanced wound dressings successfully eliminated a Staphylococcus aureus mediated experimental infection in a chronic wound murine model showing their efficacy for the treatment of these complicated non-healing wounds. The strategy of advanced medicated wound dressings developed here may be used as a potential methodology for the fabrication of functional combinatorial materials that offer the ability to eradicate bacterial infections.

The Effect of Topical Gel Secretome Hypoxia Mesenchymal Stem Cells (SH-MSCs) on TGF-Β and IL-6 Gene Expression in Wistar Rats Excision Wound Models

Wounds on the skin result in damage to the epithelial tissue and skin structure, hampering wound healing and causing acute wounds to become chronic. Secretome Hypoxia Mesenchymal Stem Cells are capable of secretes cytokines and growth factors, including TGF-β which are useful for wound healing. IL-6 is a pro-inflammatory cytokine that is produced in infectious lesions and is also important in wound closure. The aim of the research was to prove the effect of topical SH-MSCs gel on TGF-β and IL-6 gene expression in male Wistar rats with an excision wound model. This study aims to prove the effect of topical gel administration secretome Hypoxia Mesenchymal Stem Cell (SH-MSCs) on TGF-β and IL-6 gene expression in male Wistar rats with an excision wound model. This study is Experimental research with Post-test Only Control Group Design. The number of samples was 18 male Wistar rats with the excision wound model divided into three groups, Group I (K-) was given a basic gel placebo, Group 2 (K+) was given a Clobetasol dose of 0.25g/kg, and Group 3 (P1) was given SH-MSCs gel at a dose of 400 μl/kg BW, treatment for 5 days, on day 6 the skin tissue was examined by RT-PCR to see the expression of the TGF-β and IL-6 genes analyzed by One Way Anova test, continued by Post Hoc LSD test. The average TGF-β gene expression in the P1 group was the highest (1.38) and the mean IL-6 gene expression in the P1 group was the lowest (0.72). One Way Anova test result showed a significant difference in TGF-β gene expression with a value of p=0.056 (p<0.05) and IL-6 p=0.47 (p<0.05). Post Hoc LSD test result on TGF-β gene expression shows that administration of 400μl/kg BW SH-MSCs can increase TGF-β gene expression and reduce IL-6 expression in Wistar rats with an excision wound model. The administration of topical gel SH-MSCs dose of 400 μl/kg BW was proven to significantly increase TGF-β levels in male Wistar rat excision wound model. The administration of topical SH MSCs dose of 400 μl/kg BW can reduce IL-6 levels in male Wistar rat excision wound models.

3D-printed electrospun fibres for wound healing.

Wound management for acute and chronic wounds has become a serious clinical problem worldwide, placing considerable pressure on public health systems. Owing to the high-precision, adjustable pore structure, and repeatable manufacturing process, 3D-printed electrospun fibre (3DP-ESF) has attracted widespread attention for fabricating wound dressing. In addition, in comparison with 2D electrospun fibre membranes fabricated by traditional electrospinning, the 3D structures provide additional guidance on cell behaviour. In this perspective article, we first summarise the basic manufacturing principles and methods to fabricate 3DP-ESF. Then, we discuss the function of 3DP-ESF in manipulating the different stages of wound healing, including anti-bacteria, anti-inflammation, and promotion of cell migration and proliferation, as well as the construction of tissue-engineered scaffolds. In the end, we provide the current challenge faced by 3DP-ESF in the application of skin wound regeneration and its promising future directions.